Department of Surgery and Breast Cancer Center, Korea Institute of Radiological and Medical Sciences, Korea Cancer Center Hospital, and Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, 215-4 Gongneung-dong, Nowon-gu, Seoul, 139-706, Korea.
World J Surg. 2011 Jun;35(6):1244-53. doi: 10.1007/s00268-011-1071-1.
Young age is regarded as an adverse prognostic factor in patients with breast cancer, especially in those with a hormone receptor (HR)-positive tumor. We investigated the prognostic significance of an age of <35 years stratified by molecular subtype based on HR and HER2.
Two large databases of Korean breast cancer patients, which included nationwide registry data, were analyzed.
In an analysis of 2,474 patients from the single institution, an age of <35 years was found to be an independent predictor of recurrence in patients with HR+/HER2- (hazard ratio 1.87; 95% confidence interval [CI]: 1.11-3.14; P=0.018), HR+/HER2+ (hazard ratio 3.09; 95% CI: 1.19-8.03; P=0.020), and HR-/HER2+ (hazard ratio 2.01; 95% CI: 1.03-3.92; P=0.040) subtypes, but not in those with the HR-/HER2- (triple-negative, TN) subtype (hazard ratio 1.08; 95% CI: 0.60-1.95; P=0.802). The results of an analysis of nationwide database data on 31,672 patients also showed that an age of <35 years significantly predicted poor cancer-specific survival in patients with HR+/HER2- (hazard ratio 3.40; 95% CI: 2.41-4.82; P<0.001), HR+/HER2+ (hazard ratio 1.96; 95% CI: 1.23-3.12; P=0.005), and HR-/HER2+ (hazard ratio 1.65; 95% CI: 1.07-2.52; P=0.022) subtypes, but again not in those with the TN subtype (hazard ratio 1.21; 95% CI: 0.88-1.67; P=0.240).
The prognostic significance of young age was found to depend on molecular subtype. An age of <35 years was a poor prognosticator in patients with the HR+/HER2-, HR+/HER2+, and HR-/HER2+ subtypes, but not in those with the TN subtype.
年龄较轻被认为是乳腺癌患者的不利预后因素，尤其是激素受体（HR）阳性肿瘤患者。我们根据 HR 和 HER2 对年轻（<35 岁）进行了分子亚型分层，研究了其预后意义。
我们分析了来自韩国两个大型乳腺癌患者数据库的数据，其中包括全国性登记数据。
在对单机构的 2474 例患者进行分析时，<35 岁是 HR+/HER2-（危险比 1.87；95%置信区间 [CI]：1.11-3.14；P=0.018）、HR+/HER2+（危险比 3.09；95% CI：1.19-8.03；P=0.020）和 HR-/HER2+（危险比 2.01；95% CI：1.03-3.92；P=0.040）亚型患者复发的独立预测因素，但在 HR-/HER2-（三阴性，TN）亚型（危险比 1.08；95% CI：0.60-1.95；P=0.802）患者中则不然。对来自全国性数据库的 31672 例患者的数据进行分析的结果也表明，<35 岁在 HR+/HER2-（危险比 3.40；95% CI：2.41-4.82；P<0.001）、HR+/HER2+（危险比 1.96；95% CI：1.23-3.12；P=0.005）和 HR-/HER2+（危险比 1.65；95% CI：1.07-2.52；P=0.022）亚型患者中显著预示着癌症特异性生存不良，但在 TN 亚型患者中（危险比 1.21；95% CI：0.88-1.67；P=0.240）则不然。
年轻的年龄预后意义取决于分子亚型。<35 岁在 HR+/HER2-、HR+/HER2+和 HR-/HER2+亚型患者中是预后不良因素，但在 TN 亚型患者中则不然。
